Bottom Line:
Endothelial biomarkers were significantly associated with insulin sensitivity (sICAM-1: r = -0.23, p = 0.009; sVCAM-1: r = -0.22, p = 0.011; sE-selectin: r = -0.21, p = 0.018) as well as with GDM status and parameters of subtle inflammation.Accordingly, sE-selectin levels at the early post partum visit predicted a later development of the disease (HR =1.02 95%CI 1.01 to 1.04, p = 0.013), however, this was attenuated after adjustment for BMI.Elevated circulating markers of endothelial dysfunction in young females with GDM history might reflect an early stage on the pathway to the manifestation of future cardiometabolic disorders.

Background: History of gestational diabetes mellitus (GDM) identifies a very young population of females predisposed for type 2 diabetes and cardiovascular disease. Endothelial dysfunction might represent a shared precursor of both disorders. Hence, this study aimed to characterize endothelial biomarkers in relation to impaired insulin sensitivity and progression to overt diabetes early after index pregnancy.

Methods: 108 women with previous GDM and 40 controls were included three to six months after delivery and underwent specific metabolic assessments including a frequently sampled intravenous glucose tolerance test and an oral glucose tolerance test. Diabetes progression was assessed in females with pGDM over 10 years of follow-up. Circulating sICAM-1 (intracellular-adhesion-molecule-1), sVCAM-1 (vascular-cell-adhesion-molecule-1) and sE-selectin, representing biomarkers of endothelial dysfunction were assessed at baseline and annually over five years.

Conclusions: Elevated circulating markers of endothelial dysfunction in young females with GDM history might reflect an early stage on the pathway to the manifestation of future cardiometabolic disorders. Timely identification of women at high risk and optimization of follow-up management might provide an opportunity to prevent disease progression.

Fig2: Association of baseline sICAM-1 (A), sVCAM-1 (B) and sE-selectin (C) with SI levels and the regression curve derived from regression analysis based on fractional polynomials.

Mentions:
A brief summary of the study sample in Table 1 shows that biomarkers of endothelial dysfunction at the baseline examination were highest in the pGDM-IR subgroup (Figure 1). This observation was also confirmed by analyses of continuous data, as sICAM-1, sVCAM-1, and sE-selectin were inversely related to SIFSIGT 3–6 month after delivery (Table 2). Regression models based on fractional polynomials revealed monotonic but non-linear relationships between insulin sensitivity at baseline (SIFSIGT) and sICAM-1 as well as sE-selectin, which were used in multivariable models (Figure 2). However, no association were observed between endothelial biomarkers and insulin secretion (Table 2).Table 1

Fig2: Association of baseline sICAM-1 (A), sVCAM-1 (B) and sE-selectin (C) with SI levels and the regression curve derived from regression analysis based on fractional polynomials.

Mentions:
A brief summary of the study sample in Table 1 shows that biomarkers of endothelial dysfunction at the baseline examination were highest in the pGDM-IR subgroup (Figure 1). This observation was also confirmed by analyses of continuous data, as sICAM-1, sVCAM-1, and sE-selectin were inversely related to SIFSIGT 3–6 month after delivery (Table 2). Regression models based on fractional polynomials revealed monotonic but non-linear relationships between insulin sensitivity at baseline (SIFSIGT) and sICAM-1 as well as sE-selectin, which were used in multivariable models (Figure 2). However, no association were observed between endothelial biomarkers and insulin secretion (Table 2).Table 1

Bottom Line:
Endothelial biomarkers were significantly associated with insulin sensitivity (sICAM-1: r = -0.23, p = 0.009; sVCAM-1: r = -0.22, p = 0.011; sE-selectin: r = -0.21, p = 0.018) as well as with GDM status and parameters of subtle inflammation.Accordingly, sE-selectin levels at the early post partum visit predicted a later development of the disease (HR =1.02 95%CI 1.01 to 1.04, p = 0.013), however, this was attenuated after adjustment for BMI.Elevated circulating markers of endothelial dysfunction in young females with GDM history might reflect an early stage on the pathway to the manifestation of future cardiometabolic disorders.

Background: History of gestational diabetes mellitus (GDM) identifies a very young population of females predisposed for type 2 diabetes and cardiovascular disease. Endothelial dysfunction might represent a shared precursor of both disorders. Hence, this study aimed to characterize endothelial biomarkers in relation to impaired insulin sensitivity and progression to overt diabetes early after index pregnancy.

Methods: 108 women with previous GDM and 40 controls were included three to six months after delivery and underwent specific metabolic assessments including a frequently sampled intravenous glucose tolerance test and an oral glucose tolerance test. Diabetes progression was assessed in females with pGDM over 10 years of follow-up. Circulating sICAM-1 (intracellular-adhesion-molecule-1), sVCAM-1 (vascular-cell-adhesion-molecule-1) and sE-selectin, representing biomarkers of endothelial dysfunction were assessed at baseline and annually over five years.

Conclusions: Elevated circulating markers of endothelial dysfunction in young females with GDM history might reflect an early stage on the pathway to the manifestation of future cardiometabolic disorders. Timely identification of women at high risk and optimization of follow-up management might provide an opportunity to prevent disease progression.